Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: The EPIC study

Raul Zamora-Ros, Sabina Rinaldi, Carine Biessy, Anne Tjønneland, Jytte Halkjær, Agnes Fournier, Marie Christine Boutron-Ruault, Sylvie Mesrine, Kaja Tikk, Reneé T. Fortner, Heiner Boeing, Jana Förster, Antonia Trichopoulou, Dimitrios Trichopoulos, Eleni Maria Papatesta, Giovanna Masala, Giovanna Tagliabue, Salvatore Panico, Rosario Tumino, Silvia PolidoroPetra H M Peeters, H. Bas Bueno-De-Mesquita, Elisabete Weiderpass, Eiliv Lund, Marcial Argüelles, Antonio Agudo, Esther Molina-Montes, Carmen Navarro, Aurelio Barricarte, Nerea Larrañaga, Jonas Manjer, Martin Almquist, Maria Sandström, Joakim Hennings, Konstantinos K. Tsilidis, Julie A. Schmidt, Kay Thee Khaw, Nicholas J. Wareham, Isabelle Romieu, Graham Byrnes, Marc J. Gunter, Elio Riboli, Silvia Franceschi

Research output: Contribution to journalArticle

Abstract

Differentiated thyroid carcinoma (TC) is threefold more common in women than in men and, therefore, a role of female hormones in the etiology of differentiated TC has been suggested. We assessed these hypotheses in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 345,157 women (mean age 51) followed for an average of 11 years, 508 differentiated TC cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. No significant associations were observed between differentiated TC risk and number of pregnancies, breast feeding, menopausal status, and age at menarche and at menopause. Significant associations were found with history of infertility problems (HR 1.70; 95% CI 1.12-2.60), a recent pregnancy (HR for ≤5 vs. >5 years before recruitment 3.87; 95% CI 1.43-10.46), menopause type (HR for surgical vs. natural menopause: 2.16; 95% CI 1.41-3.31), oral contraceptive (OC) use at recruitment (HR: 0.48; 95% CI 0.25-0.92) and duration of OC use (HR for ≥9 vs. ≤1 year: 0.66; 95% CI: 0.50-0.89). An increased risk was also found with hormone replacement therapy use at recruitment (HR=1.30, 95% CI 1.02-1.67), but this was not significant after adjustment for type of menopause (HR=1.22, 95% CI 0.95-1.57). Overall, our findings do not support a strong role of reproductive and menstrual factors, and female hormone use in the etiology of differentiated TC. The few observed associations may be real or accounted for by increased surveillance in women who had infertility problems, recent pregnancies or underwent surgical menopause.

Original languageEnglish
Pages (from-to)1218-1227
Number of pages10
JournalInternational Journal of Cancer
Volume136
Issue number5
DOIs
Publication statusPublished - Mar 1 2015

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Keywords

  • Differentiated thyroid carcinoma
  • EPIC
  • Hormone use
  • Menstrual factors
  • Reproductive factors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Zamora-Ros, R., Rinaldi, S., Biessy, C., Tjønneland, A., Halkjær, J., Fournier, A., Boutron-Ruault, M. C., Mesrine, S., Tikk, K., Fortner, R. T., Boeing, H., Förster, J., Trichopoulou, A., Trichopoulos, D., Papatesta, E. M., Masala, G., Tagliabue, G., Panico, S., Tumino, R., ... Franceschi, S. (2015). Reproductive and menstrual factors and risk of differentiated thyroid carcinoma: The EPIC study. International Journal of Cancer, 136(5), 1218-1227. https://doi.org/10.1002/ijc.29067